My Wife's Test Results And Questions

My wife has been feeling terrible all of 2014: bloating, loose bowels, floating, light coloured stools, general aching, abdominal cramping (especially LLQ), fatigue, loss of libido, feelings of depression and anxiety. Many symptoms started mid 2013, but they have gotten worse this year.

She had a blood test for celiac, and here are the results:

tTg-Iga Ab 5

tTg-IgG Ab 3

DGP-IgA Ab 162

DGP-IgG Ab 3

Result Range indication for tTG and DPG

Negative < 20

Weak Positive 20-30

Moderate to Strong Positive >30

Test results: Positive

Feelings towards test results: :,(

My first question is: Could anything other than Celiac produce these results? How positive is the test (90%, 99%, 99.9%)?

She will have a GI appointment where they will do a biopsy in a month or so (date not confirmed yet). So far this week, she has been off gluten and it seems already she has noticed improvement. The GI's office wants her to keep eating gluten until the appointment (the receptionist said that it might be an allergy and not Celiac). What are your thoughts? Can she just start eating gluten again a week before the appointment if need be, or does she have to feel terrible for another month?

I'm sure she'll create her own account here soon, but I had a bit of time, so I thought I'd ask on her behalf. Thanks community.

She should keep eating gluten until the testing is completed. She might be able to get in sooner if they have a standby list for openings. Often people have worse symptoms from returning to eating gluten after being off it for awhile. So stopping gluten for a couple weeks and restarting it won't be fun. She doens't need to eat a lot fo gluten. They often say something like 2 slices of wheat bread per day.

DGP is deminated gliaden protein antibodies. It is very specific and very low chance of a false positive. Plus she had symptoms change after stopping gluten. That means that gluten is casuing a reaction for some reason.

She might feel somewhat better if she stops eating dairy now. That won't affect her celiac testing. But often people have problems with dairy at first. She can also try taking pepto bismol If she has problems with trapped gas she can try peppermint tea.

That DGP IgA tests is 93-96% specific to celiac disease as seen on page 12 of this report: http://www.worldgast..._long_FINAL.pdf That's pretty specific, especially combined with those classic celiac disease symptoms you listed. It's not uncommon for celiacs to test positive in only a few tests, or even just one so don't worry about those others being negative. The DGP tests in particular are very good at picking up early celiac disease unlike the tTG tests.

She should keep eating gluten prior to the biopsy. Most doctors recommend a minimum two week gluten challenge prior to testing; some want as much as 4 weeks. If she needs to go a bit lighter on the gluten now just make sure to add more gluten (about 2 slices of bread per day) back into her diet about three weeks prior to testing. The more gluten she eats now, the better chance of damage showing up in the biopsy.

The comment about the allergy makes no sense at all. That receptionist has no clue! The allergy response is IgE based and not related to the IgA and IgG immune response that is tested for in celiac disease. It is possible to have a wheat allergy and a gluten sensitivity (like celiac disease) but the tests she had done would not show an allergy... It would be like taking a urine sample to check your blood counts - totally unrelated.

Ditto the the dairy idea. About half of all celiacs are lactose intolerant when diagnosed (the damaged villi can't make lactase) but many celiacs regain the ability to digest milk sugars after they have healed, which usually takes at least 6 months.